Analysis of Suicidal Behavior in Adult Inpatients with Anorexia Nervosa: Prevalence of Suicide Attempts and Non-Suicidal Self-Injury and Associated Factors-Data Before and After the COVID-19 Pandemic.

Background/

Objectives

Anorexia nervosa (AN) has a high mortality rate frequently related to suicidality; however, there are few studies on suicide attempts (SAs) and non-suicidal self-injuries (NSSIs) in adult inpatients with AN. This study aims to describe SA and NSSI prevalence and related clinical and sociodemographic factors in adult inpatients with AN.

Methods

We retrospectively analyzed data on 298 inpatients hospitalized between 2014 and 2023. Suicidality and clinical and sociodemographic data were collected by experienced psychiatrists; then, the patients completed a battery of self-report questionnaires investigating eating-related and general psychopathology.

Results

A total of 9.7% of the inpatients reported an SA in their lifetime, and 13.4% reported NSSI. The percentages were lower among patients with restricter-type AN (5.6% SA and 6.6% NSSI) and higher among patients with binge-purging AN (18% SA and 27% NSSI). SAs were associated with unemployment, binge-purging AN, personality disorders, and lifetime sexual abuse; NSSIs were correlated with family psychiatric disorders, binge-purging AN, personality disorders, body dissatisfaction, restriction, and eating-related concerns. No differences emerged in the frequency of reported suicidality between patients tested before and after the COVID-19 pandemic.

Conclusions

Suicidality is a relevant issue in AN. Many factors in the history of the patients and their eating-related pathologies should be considered as potentially associated with SA and NSSI and carefully assessed.